Christina Holliday
RE: Discussion – Week 1
COLLAPSE
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I reviewed the website for the American Psychiatric Association (APA) and its relation to EBP (evidence-based practice). The APA is the world’s leading psychiatric organization in the world. They have over 38 thousand members that span across 100 countries. According to the definition of EBP by the American Speech-Language-Hearing Association (ASHA), EBP consists of 3 components. They are clinical expertise/expert opinion, external and internal evidence, and client/patient/caregiver perspectives (ASHA, n.d.) Another definition of evidence based practice Is, “Evidence-based practice (EBP) is the objective, balanced, and responsible use of current research and the best available data to guide policy and practice decisions, such as that outcomes for consumers are improved (NICIC, 2019).”
It appears from several places on the APA website they follow EBP. “APA practice guidelines provide evidence-based recommendations for the assessment and treatment of psychiatric disorders (APA, 202)”. According to the APA website, the use of EBP in their organization is, “intended to assist in clinical decision making by presenting systematically developed patient care strategies in a standardized format (APA, 2020)”. It is evident from their mission, vision, values, and goals that the APA incorporates EBP into their practices and philosophy. Included in the APA’s mission statement is the desire to promote psychiatric education and research. Included in the APA’s goals are “to improve research into all aspects of mental illness, including causes, prevention, and treatment of psychiatric disorders (APA, 2020).
The information I found on the APA website did not change my perception of the organization. It actually strengthened my belief in the organization. I am pursuing my nurse practitioner in psychiatric mental health. This is an organization I will utilize throughout my career. I was very pleased to see they incorporate EBP in their practices and philosophies.
References
(n.d.). Retrieved from https://www.psychiatry.org/about-apa/vision-mission-values-goals
Evidence-Based Practice (EBP). (n.d.). Retrieved from https://www.asha.org/Research/EBP/
Evidence-based Practices (EBP). (2019, October 28). Retrieved from https://nicic.gov/evidence-based-practices-ebp
Response
Hi Christina, evidence-based practice refers to the incorporation of the best available research findings with clinical expertise while considering patients’ characteristics, preferences, and culture. The American Psychiatric Association is an example of organizations that incorporate evidence-based when attending to their clients. By doing so, clinicians are assisted in making clinical decisions by presenting developed patient care plans systematically and in a standardized plan (Rousseau & Gunia, 2016). Before the introduction of EBP in the APA organization, its healthcare professionals were conflicting on what evidence to be used to ensure quality patient care. Levant & Sperry (2016) cites that some clinicians valued randomized clinical trials as the sole evidence for best practice, while others argued that other forms of evidence were valuable. EBP in psychology recognizes the clinician’s expertise, patient’s values, culture, and preferences, and the best evidence from research to improve patient outcomes and the profession. Levant & Sperry (2016) argues that EBP enables the APA organization to speak with one voice and avoids confusion among its professionals, the media, public, and insurance companies.
References
Levant, R. F., & Sperry, H. A. (2016). Components of evidence-based practice in psychology. In N. Zane, G. Bernal, & F. T. L. Leong (Eds.), Cultural, racial, and ethnic psychology book series. Evidence-based psychological practice with ethnic minorities: Culturally informed research and clinical strategies (p. 15–29). American Psychological Association. https://doi.org/10.1037/14940-002
Rousseau, D. M., & Gunia, B. C. (2016). Evidence-based practice: The psychology of EBP implementation. Annual Review of Psychology, 67, 667-692.
https://doi.org/10.1146/annurev-psych-122414-033336
Adam Waruszewski
Main Post – Adam Waruszewski
COLLAPSE
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As a nurse studying to become a mental health nurse practitioner, the first organization that came to mind was the American Psychiatric Nurses Association (APNA). As with most professional organizations, they offer networking opportunities, continuing education, and keeping members informed of the most current evidence-based practice (EBP) methods (American Psychiatric Nurses Association, 2020). The vision statement of the APNA ends by stating they work “to promote evidence-based advances in recovery-focused assessment, diagnosis, treatment, and evaluation of persons with mental illness and substance use disorders” (American Psychiatric Nurses Association, 2020, para. 2).
While the APNA promotes EBP, studies have shown that while psych nurses agree with using EBP methods in their practice, very few actually implemented these research methods into their practice (Patelarou, et al., 2016). So, why is there a such a disconnect when EBP has been proven to be so successful in improving patient outcomes? Perhaps the answer lies within the definition itself.
“Evidence-based practice (EBP) enhances healthcare quality, improves patient outcomes, reduces costs, and empowers clinicians” (Melnyk & Fineout-Overholt, 2019, p. 7). As a nurse who formally worked in a federally qualified health center (FQHC), I have seen both the benefits and costs of EBP. There was a textbook example of how FQHC’s were able to prove that lifestyle changes, in addition to medications, were able to make a huge difference in patient outcomes for patients with Type II diabetes for the better (Melnyk & Fineout-Overholt, 2019, p. 14). However, this comes at a cost. While it was helpful for certain metrics, like point-of-care HbA1c testing, it began to make treatment cookie-cutter. Every patient with Type II diabetes had their HbA1c screened before the provider even entered the exam room. This was a metric we had to follow based on HRSA guidelines, and my practice ended up having the number one improvement in our state 2 years in a row. But, when the providers had to change the plan of care to be more patient-specific, we had to defend the reasoning. This took away from treating each patient as an individual, and this created even more work for both the provider and nursing staff. As with everything, there are both positive and negative attributes.
This does not diminish the importance of EBP, and having a resource such as the APNA is critical to stay informed of the most updated EBP. If anything, one would be more inclined to take advantage of their resources to improve one’s practice. And, if one discovers something in their personal practice that could be helpful systemically, he or she should be supported by his or her employer to explore and research this idea further. Hopefully, this is just the next best step on the road to building our professional practice and portfolios.
References
American Psychiatric Nurses Association. (2020). About the American Psychiatric Nurses Association: An Introduction. Retrieved from American Psychiatric Nurses Association: https://www.apna.org/i4a/pages/index.cfm?pageid=3277
Melnyk, B. M., & Fineout-Overholt, E. (2019). Evidence-Based Practice in Nursing and Healthcare. Philadelphia: Wolters Kluwer.
Patelarou, A. E., Katsouli, K., Stamou, A., Vivilaki, V., Koukia, E., Sifaki-Pistolla, D., & Patelarou, E. (2016, December 2). Attitudes, knowledge and perceptions. Retrieved from Archives of Hellenic Medicine: http://mail.mednet.gr/archives/2017-5/pdf/636.pdf
Response
Hi Adam, EBP is crucial in the provision of effective care to improve patient outcomes. EBP does not only include the best evidence from research in making clinical decisions, but it also takes into account the clinician’s knowledge, skills, and experience and practice context. Besides, patients’ values, including financial capacity and social support, are considered when making clinical decisions, which foster patient-centred care (Di Bartolo & Braun, 2016). While most organizations advocate the utilization of EBP, including APA, a significant number of their professionals have embraced it. In a study conducted by Hamaideh (2016) in Saudi Arabia, it was found that EBP has not been adopted among psychiatric nurses because significant sources of knowledge relied on social interactions and nurses’ experiences instead of research evidence. Hamaide (2016) argues that this was because nurses had insufficient time to find research articles, difficulty in comprehending research materials, and the scarcity of research resources. Therefore, to realize enhanced patient outcomes, healthcare organizations should provide their nurses with adequate knowledge, skills, and resources through mentoring and workshops.
References
Di Bartolo, C. A., & Braun, M. K. (2017). Introduction: Evidence-Based Practice in Patient-Centered Care. In Pediatrician’s Guide to Discussing Research with Patients (pp. 1-16). Springer, Cham.
Hamaideh, S. H. (2016). Sources of Knowledge and Barriers of Implementing Evidence-Based Practice Among Mental Health Nurses in Saudi Arabia. Perspectives in Psychiatric Care, 53(3), 190-198. https:// DOI: 10.1111/ppc.12156